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35 Industrial Tract Anx Hudson NY 12534-1505 | |
(518) 291-8844 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 35 Industrial Tract Anx, Hudson, New York |
Authorized Official Name and Position | Kristen Bernockie (OWNER) |
Authorized Official Contact | 5186539699 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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35 Industrial Tract Anx Hudson NY 12534-1505 Ph: (518) 291-8844 | 35 Industrial Tract Anx Hudson NY 12534-1505 Ph: (518) 291-8844 |
NPI Number | 1043908429 |
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Provider Enumeration Date | 04/25/2023 |
Last Update Date | 03/11/2024 |
Medicare PECOS PAC ID | 2466891197 |
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Medicare Enrollment ID | O20240415002112 |
Identifier | Type | State | Issuer |
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1043908429 | NPI | - | NPPES |
07742996 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kristen M Bernockie |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891368080 PECOS PAC ID: 7113323643 Enrollment ID: I20210909001162 |
Prime Columbia Greene Medical Associates, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 949 Columbia St, Hudson, NY 12534 Phone: 518-828-7188 Fax: 518-828-5049 |